Incretin Hypersecretion in Gestational Diabetes Mellitus

Context: Incretins are crucial stimulators of insulin secretion following food intake. Data on incretin secretion and action during pregnancy are sparse. Objective: The aim of the study was to investigate the incretin response during an oral glucose tolerance test (OGTT) in pregnant women with and w...

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Published in:The journal of clinical endocrinology and metabolism 2022-06, Vol.107 (6), p.e2425
Main Authors: Fritsche, Louise, Heni, Ma, Eckstein, Sabine S, Hummel, Julia, Schurmann, Anette, Haring, Hans-Ulrich, Preibl, Hubert, Birkenfeld, Andreas L, Peter, Andreas, Fritsche, Andreas, Wagner, Robert
Format: Article
Language:English
Subjects:
Analysis
Aprotinin
Dextrose
Diabetes in pregnancy
Ethylenediaminetetraacetic acid
Glucagon
Glucose
Glucose tolerance tests
Insulin
Pharmaceutical industry
Pregnant women
Sitagliptin
Type 2 diabetes
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container_issue 6
container_start_page e2425
container_title The journal of clinical endocrinology and metabolism
container_volume 107
creator Fritsche, Louise
Heni, Ma
Eckstein, Sabine S
Hummel, Julia
Schurmann, Anette
Haring, Hans-Ulrich
Preibl, Hubert
Birkenfeld, Andreas L
Peter, Andreas
Fritsche, Andreas
Wagner, Robert
description Context: Incretins are crucial stimulators of insulin secretion following food intake. Data on incretin secretion and action during pregnancy are sparse. Objective: The aim of the study was to investigate the incretin response during an oral glucose tolerance test (OGTT) in pregnant women with and without gestational diabetes mellitus (GDM). Design: We analyzed data from the ongoing observational PREG study (NCT 04270578). Setting: The study was conducted at the University HospitalTubingen. Participants: We examined 167 women (33 with GDM) during gestational week 27 [+ or -] 2.2. Intervention: Subjects underwent 5-point OGTT with a 75-g glucose load. Main outcome measures: We assessed insulin secretion and levels of total glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), glicentin, and glucagon during OGTT. Linear regression was used to analyze the relation of GLP-1 and glucose with insulin secretion and the association of incretin levels on birth outcome. Results: Insulin secretion was significantly lower in women with GDM (P< 0.001). Postload GLP-1 and GIP were ~20% higher in women with GDM (all P
doi_str_mv 10.1210/clinem/dqac095
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Data on incretin secretion and action during pregnancy are sparse. Objective: The aim of the study was to investigate the incretin response during an oral glucose tolerance test (OGTT) in pregnant women with and without gestational diabetes mellitus (GDM). Design: We analyzed data from the ongoing observational PREG study (NCT 04270578). Setting: The study was conducted at the University HospitalTubingen. Participants: We examined 167 women (33 with GDM) during gestational week 27 [+ or -] 2.2. Intervention: Subjects underwent 5-point OGTT with a 75-g glucose load. Main outcome measures: We assessed insulin secretion and levels of total glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), glicentin, and glucagon during OGTT. Linear regression was used to analyze the relation of GLP-1 and glucose with insulin secretion and the association of incretin levels on birth outcome. Results: Insulin secretion was significantly lower in women with GDM (P&lt; 0.001). Postload GLP-1 and GIP were ~20% higher in women with GDM (all P&lt;0.05) independent of age, body mass index, and gestational age. GLP-1 increase was associated with insulin secretion only in GDM, but not in normal glucose tolerance. Postprandial GLP-1 levels were negatively associated with birth weight. Conclusions: The more pronounced GLP-1 increase in women with GDM could be part of a compensatory mechanism counteracting GLP-1 resistance. Higher GLP-1 levels might be protective against fetal overgrowth. 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Data on incretin secretion and action during pregnancy are sparse. Objective: The aim of the study was to investigate the incretin response during an oral glucose tolerance test (OGTT) in pregnant women with and without gestational diabetes mellitus (GDM). Design: We analyzed data from the ongoing observational PREG study (NCT 04270578). Setting: The study was conducted at the University HospitalTubingen. Participants: We examined 167 women (33 with GDM) during gestational week 27 [+ or -] 2.2. Intervention: Subjects underwent 5-point OGTT with a 75-g glucose load. Main outcome measures: We assessed insulin secretion and levels of total glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), glicentin, and glucagon during OGTT. Linear regression was used to analyze the relation of GLP-1 and glucose with insulin secretion and the association of incretin levels on birth outcome. Results: Insulin secretion was significantly lower in women with GDM (P&lt; 0.001). Postload GLP-1 and GIP were ~20% higher in women with GDM (all P&lt;0.05) independent of age, body mass index, and gestational age. GLP-1 increase was associated with insulin secretion only in GDM, but not in normal glucose tolerance. Postprandial GLP-1 levels were negatively associated with birth weight. Conclusions: The more pronounced GLP-1 increase in women with GDM could be part of a compensatory mechanism counteracting GLP-1 resistance. Higher GLP-1 levels might be protective against fetal overgrowth. 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Data on incretin secretion and action during pregnancy are sparse. Objective: The aim of the study was to investigate the incretin response during an oral glucose tolerance test (OGTT) in pregnant women with and without gestational diabetes mellitus (GDM). Design: We analyzed data from the ongoing observational PREG study (NCT 04270578). Setting: The study was conducted at the University HospitalTubingen. Participants: We examined 167 women (33 with GDM) during gestational week 27 [+ or -] 2.2. Intervention: Subjects underwent 5-point OGTT with a 75-g glucose load. Main outcome measures: We assessed insulin secretion and levels of total glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), glicentin, and glucagon during OGTT. Linear regression was used to analyze the relation of GLP-1 and glucose with insulin secretion and the association of incretin levels on birth outcome. Results: Insulin secretion was significantly lower in women with GDM (P&lt; 0.001). Postload GLP-1 and GIP were ~20% higher in women with GDM (all P&lt;0.05) independent of age, body mass index, and gestational age. GLP-1 increase was associated with insulin secretion only in GDM, but not in normal glucose tolerance. Postprandial GLP-1 levels were negatively associated with birth weight. Conclusions: The more pronounced GLP-1 increase in women with GDM could be part of a compensatory mechanism counteracting GLP-1 resistance. Higher GLP-1 levels might be protective against fetal overgrowth. Key Words: GDM, incretins, GLP-1, birth weiqht</abstract><pub>Oxford University Press</pub><doi>10.1210/clinem/dqac095</doi></addata></record>
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subjects Analysis
Aprotinin
Dextrose
Diabetes in pregnancy
Ethylenediaminetetraacetic acid
Glucagon
Glucose
Glucose tolerance tests
Insulin
Pharmaceutical industry
Pregnant women
Sitagliptin
Type 2 diabetes
title Incretin Hypersecretion in Gestational Diabetes Mellitus
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